People needing A&E may no longer be able to just turn up

PATIENTS may only be admitted to A&E with a referral or if they arrive by ambulance, under proposals submitted to ministers.

The Royal College of Emergency Medicine says that in order to reduce transmission of coronavirus, patients may have to get approval from their GP or NHS 111 before receiving emergency care, although the rule could be broken in “life or death” cases.

The experts warn that more people will die from Covid-19 if A&E departments return to the overcrowding that was widespread before the pandemic.

In a second part of its plan, “hot clinics” will be set up for patients who are referred with less time-critical complaints, such as severe headaches requiring a scan. “Non-emergency” patients would be separated from the emergency department.

The third measure would increase clinicians taking NHS 111 calls. The calls have been shown to increase appropriate and timely referrals, as well as reduce unnecessary ambulance call-outs.

Dr Katherine Henderson, president of the Royal College of Emergency Medicine, said: “Going back to how we used to operate is not an option – patients will die if we do.

“It was just four months ago when we were seeing overcrowding on a record scale in emergency departments. It was unacceptable then and put lives at risk. To go back to that now will lead to avoidable patient and staff illness or death.

“If departments are crowded, we cannot protect patients and staff. Crowding has long been associated with avoidable mortality, and Covid-19 reinforces and multiplies this risk.

“We must have a way to enforce social distancing to ensure that patients do not become infected while seeking healthcare.

“If supermarkets can get this right, then the very institution that people entrust with their health must do so, too.”